Urinary tract infections were described on an Egyptian papyrus around 1550 BC
Roughly 400 million urinary tract infections occur every year, and they are the most common bacterial infection in women; half of all women get at least one in their lifetime. The complaint is ancient too: the first documented description appears in the Ebers Papyrus, dated to about 1550 BC.
An infection can strike the bladder or urethra, known as a lower infection, or climb to the kidneys, called pyelonephritis. Lower infections typically bring burning on urination, lower abdominal pain and a persistent urge to go; kidney infections add fever or flank pain and sometimes nausea. In healthy women symptoms last about six days on average. Kidney involvement usually follows a spreading bladder infection, though bacteria carried in the blood can also seed it.
Gut-dwelling E. coli causes about 75 percent of uncomplicated cases and 65 percent of complicated ones. Infections linked to catheters involve a wider cast, including Klebsiella pneumoniae and Pseudomonas aeruginosa, which can build biofilms on the tubing. Risk rises with being female, diabetes, catheter use, family history, spermicide use and holding urine in. Among young sexually active women, sex accounts for 75 to 90 percent of bladder infections, a pattern once nicknamed honeymoon cystitis, yet these infections are not classed as sexually transmitted.
The classic signs can vanish at the extremes of age. In young children a fever may be the only clue, which is why many medical associations recommend a urine culture for feverish girls under two and uncircumcised boys under one. Older people may show only incontinence, confusion or fatigue, and some first come to attention with sepsis. A rare catheter-related form even turns the urine purple.
Uncomplicated cases are usually treated with a short antibiotic course, and resistance to many of those drugs is growing. Episodes peak between the ages of 16 and 35, recurrences are common, and up to 10 percent of women have an infection in any given year.
Source: Urinary tract infection
